Consider discontinuing propranolol during intercurrent illness, especially in the setting of restricted oral intake, to prevent hypoglycaemia.
Hyperthyroidism — beta-blockers may mask clinical signs, e.g. tachycardia.
Phaeochromocytomas — beta-blockers may aggravate hypertension; an alpha-blocker should be given first.
Beta-blockers may reduce the response to usual doses of adrenaline (epinephrine) for anaphylaxis.
Myasthenia symptoms — may worsen.
Beta-blockers may worsen first-degree AV block.
Beta-blockers may impair peripheral circulation and exacerbate symptoms of peripheral arterial disease (PAD).
Beta-blockers may mask important signs of acute hypoglycaemia (e.g. tachycardia,
tremor). They may also increase the incidence and severity of hypoglycaemia but data are conflicting.
Can precipitate bronchospasm.
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